State Archives Of North Carolina
Department of Natural and Cultural Resouces
America 250 NC Local Grants: County Committees Application
For Certified America 250 NC Community Partners
Project Title
*
Applicant/Project Sponsor
The lead applicant will be the fiscal agent for the project and will be responsible for final reporting.
Contact Name
*
Organization
*
County
*
Website
America250@nc.dncr.gov
E-mail
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant Type
*
Please Select
Official County 250 Committee
County Name
Project Director
The project director will lead the day-to-day operations of the project and will ensure that the project is kept on time, within budget, and that all deliverables are met. The project director will be the primary point of contact for the American 250 NC grants officer.
Project Director Name
*
Organization
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Budget Officer
The Budget Officer will be the chief fiscal officer for the lead applicant and will be responsible for ensuring grant funds are spent according to the grant application and all applicable state laws.
Budget Officer Name
*
Organization
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Authorizing Officer
If different from above
Authorizing Officer Name
Organization
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Project Summary
See instructions prior to completing this section
Abstract
*
Please briefly summarize the applicant, the project’s goal or purpose, and the subject matter the project addresses. This description may be used in publicity.
0/2000
America 250 NC Themes
*
Explain how this project relates specifically (not tangentially) to the themes of America 250 NC. https://www.america250.nc.gov/about/commemorative-themes
0/1000
NC County Tier
*
Please Select
Tier 1
Tier 2
Tier 3
Need Help? Visit https://www.commerce.nc.gov/grants-incentives/county-distress-rankings-tiers
Type of Project
*
Please Select
Strategic Planning for Local America 250 NC Committee
Public Art or Mural
Wayside
Local Marker
Local Exhibit
Online Exhibit
Research
Educational Outreach
Event Expenses
Archaeology
Please see instructions for detailed description of eligible projects
Project Narrative
*
See instructions prior to completion.
0/7000
External Review
*
Yes
No
External Review Process
Please describe the process. What is your plan to ensure the accuracy of the historical information?
Communications Plan
*
See instructions prior to completion.
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Project Deliverables/Impact
Deliverables/Expected Outcome
*
See instructions prior to completion.
Measurement of Success
*
See instructions prior to completion.
Participation and Access
*
See instructions prior to completion.
0/1000
Longevity/Lasting Impact
*
See instructions prior to completion.
0/500
Partnerships
*
See instructions prior to completion.
Project Timeline Summary
*
See instructions prior to completion.
0/1000
Budget Summary
*
Download Budget Form
Budget Form
*
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Conflict of Interest Policy/Ethics Statement
*
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